The Common Vein Copyright 2008
Definition
Esophagitis is an inflammatory response of the esophagus to multiple causes, the most common of which is due to reflux of acidic gastric contents through an incompetent lower esophageal sphincter into the distal esophagus. It is thus considered in this instance as a chemical burn.
It is characterized by a reddened inflammed and swollen and often erosive mucosa, resulting in pain that may be epigastric or substernal. This presentation may simulate cardiac pain.
Long standing esophagitis may be complicated by a peptic stricture or Barrett’s esophagus which is a premalignant condition.
The diagnosis is suspected clinically by the classical presentation of substernal burning in the presence of symptoms of reflux, waterbrash (hypersalivation), and halitosis, with relief from antacid therapy. Documentation of the disease is best achieved by endoscopy, with double contrast barium swallow being less sensitive to the disease.
The mainstay of therapy for GERD with esophagitis remains the proton pump inhibitors (PPI) and the H2 Blockers.
The Normal (left) and Abnormal (right) Red and Swollen GE junction – Reflux Esophagitis |
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The GE junction is a distinct border as seen normally in the left image. The distal esophagus is normally a pearl white hue, while the gastric mucosa is a pink hue. In esophagitis the hyperemic inflammatory changes make the border less distinct (right image)
01239b01.800 esophagus stomach GE junction gastroesophageaal junction inflammed inflammation GERD red swollen reflux esophagitis grosspathology Courtesy Ashley Davidoff MD |
Quinidine Ulcer |
Courtesy Ashley Davidoff MD 01258 01258b01 esophagus + quinidine ulcer barium swallow inflammation upper GI UGI imaging radiology contrast X-Ray |
Linear Erosion at the GE Junction |
01252c Courtesy Ashley Davidoff MD 01252 code esophagus + fx linear erosion + dx reflux esophagitis + barium swallow upper GI UGI imaging radiology contrast X-Ray |
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DOMElement Object ( [schemaTypeInfo] => [tagName] => td [firstElementChild] => (object value omitted) [lastElementChild] => (object value omitted) [childElementCount] => 2 [previousElementSibling] => [nextElementSibling] => [nodeName] => td [nodeValue] => Normal (a) and Reflux Esophagitis (b) [nodeType] => 1 [parentNode] => (object value omitted) [childNodes] => (object value omitted) [firstChild] => (object value omitted) [lastChild] => (object value omitted) [previousSibling] => (object value omitted) [nextSibling] => (object value omitted) [attributes] => (object value omitted) [ownerDocument] => (object value omitted) [namespaceURI] => [prefix] => [localName] => td [baseURI] => [textContent] => Normal (a) and Reflux Esophagitis (b) )
DOMElement Object ( [schemaTypeInfo] => [tagName] => table [firstElementChild] => (object value omitted) [lastElementChild] => (object value omitted) [childElementCount] => 1 [previousElementSibling] => (object value omitted) [nextElementSibling] => (object value omitted) [nodeName] => table [nodeValue] => Linear Ulcer in a Hyperemic Background of Diffuse Esophagitis On closer inspection of the GE junction, a linear ulcer is seen (overlaid in right image). It is even painful to look at. 01239c esophagus stomach GE junction gastroesophageaal junction inflammed inflammation GERD red swollen reflux esophagitis linear ulcer grosspathology Courtesy Ashley Davidoff MD [nodeType] => 1 [parentNode] => (object value omitted) [childNodes] => (object value omitted) [firstChild] => (object value omitted) [lastChild] => (object value omitted) [previousSibling] => (object value omitted) [nextSibling] => (object value omitted) [attributes] => (object value omitted) [ownerDocument] => (object value omitted) [namespaceURI] => [prefix] => [localName] => table [baseURI] => [textContent] => Linear Ulcer in a Hyperemic Background of Diffuse Esophagitis On closer inspection of the GE junction, a linear ulcer is seen (overlaid in right image). It is even painful to look at. 01239c esophagus stomach GE junction gastroesophageaal junction inflammed inflammation GERD red swollen reflux esophagitis linear ulcer grosspathology Courtesy Ashley Davidoff MD )
DOMElement Object ( [schemaTypeInfo] => [tagName] => td [firstElementChild] => (object value omitted) [lastElementChild] => (object value omitted) [childElementCount] => 1 [previousElementSibling] => [nextElementSibling] => [nodeName] => td [nodeValue] => On closer inspection of the GE junction, a linear ulcer is seen (overlaid in right image). It is even painful to look at. 01239c esophagus stomach GE junction gastroesophageaal junction inflammed inflammation GERD red swollen reflux esophagitis linear ulcer grosspathology Courtesy Ashley Davidoff MD [nodeType] => 1 [parentNode] => (object value omitted) [childNodes] => (object value omitted) [firstChild] => (object value omitted) [lastChild] => (object value omitted) [previousSibling] => (object value omitted) [nextSibling] => (object value omitted) [attributes] => (object value omitted) [ownerDocument] => (object value omitted) [namespaceURI] => [prefix] => [localName] => td [baseURI] => [textContent] => On closer inspection of the GE junction, a linear ulcer is seen (overlaid in right image). It is even painful to look at. 01239c esophagus stomach GE junction gastroesophageaal junction inflammed inflammation GERD red swollen reflux esophagitis linear ulcer grosspathology Courtesy Ashley Davidoff MD )
DOMElement Object ( [schemaTypeInfo] => [tagName] => td [firstElementChild] => (object value omitted) [lastElementChild] => (object value omitted) [childElementCount] => 1 [previousElementSibling] => [nextElementSibling] => [nodeName] => td [nodeValue] => Linear Ulcer in a Hyperemic Background of Diffuse Esophagitis [nodeType] => 1 [parentNode] => (object value omitted) [childNodes] => (object value omitted) [firstChild] => (object value omitted) [lastChild] => (object value omitted) [previousSibling] => (object value omitted) [nextSibling] => (object value omitted) [attributes] => (object value omitted) [ownerDocument] => (object value omitted) [namespaceURI] => [prefix] => [localName] => td [baseURI] => [textContent] => Linear Ulcer in a Hyperemic Background of Diffuse Esophagitis )
DOMElement Object ( [schemaTypeInfo] => [tagName] => table [firstElementChild] => (object value omitted) [lastElementChild] => (object value omitted) [childElementCount] => 1 [previousElementSibling] => [nextElementSibling] => (object value omitted) [nodeName] => table [nodeValue] => [nodeType] => 1 [parentNode] => (object value omitted) [childNodes] => (object value omitted) [firstChild] => (object value omitted) [lastChild] => (object value omitted) [previousSibling] => (object value omitted) [nextSibling] => (object value omitted) [attributes] => (object value omitted) [ownerDocument] => (object value omitted) [namespaceURI] => [prefix] => [localName] => table [baseURI] => [textContent] => )
DOMElement Object ( [schemaTypeInfo] => [tagName] => td [firstElementChild] => (object value omitted) [lastElementChild] => (object value omitted) [childElementCount] => 1 [previousElementSibling] => [nextElementSibling] => [nodeName] => td [nodeValue] => [nodeType] => 1 [parentNode] => (object value omitted) [childNodes] => (object value omitted) [firstChild] => (object value omitted) [lastChild] => (object value omitted) [previousSibling] => (object value omitted) [nextSibling] => (object value omitted) [attributes] => (object value omitted) [ownerDocument] => (object value omitted) [namespaceURI] => [prefix] => [localName] => td [baseURI] => [textContent] => )
DOMElement Object ( [schemaTypeInfo] => [tagName] => table [firstElementChild] => (object value omitted) [lastElementChild] => (object value omitted) [childElementCount] => 1 [previousElementSibling] => (object value omitted) [nextElementSibling] => (object value omitted) [nodeName] => table [nodeValue] => The Normal (left) and Abnormal (right) Red and Swollen GE junction – Reflux Esophagitis The GE junction is a distinct border as seen normally in the left image. The distal esophagus is normally a pearl white hue, while the gastric mucosa is a pink hue. In esophagitis the hyperemic inflammatory changes make the border less distinct (right image) 01239b01.800 esophagus stomach GE junction gastroesophageaal junction inflammed inflammation GERD red swollen reflux esophagitis grosspathology Courtesy Ashley Davidoff MD [nodeType] => 1 [parentNode] => (object value omitted) [childNodes] => (object value omitted) [firstChild] => (object value omitted) [lastChild] => (object value omitted) [previousSibling] => (object value omitted) [nextSibling] => (object value omitted) [attributes] => (object value omitted) [ownerDocument] => (object value omitted) [namespaceURI] => [prefix] => [localName] => table [baseURI] => [textContent] => The Normal (left) and Abnormal (right) Red and Swollen GE junction – Reflux Esophagitis The GE junction is a distinct border as seen normally in the left image. The distal esophagus is normally a pearl white hue, while the gastric mucosa is a pink hue. In esophagitis the hyperemic inflammatory changes make the border less distinct (right image) 01239b01.800 esophagus stomach GE junction gastroesophageaal junction inflammed inflammation GERD red swollen reflux esophagitis grosspathology Courtesy Ashley Davidoff MD )
DOMElement Object ( [schemaTypeInfo] => [tagName] => td [firstElementChild] => (object value omitted) [lastElementChild] => (object value omitted) [childElementCount] => 1 [previousElementSibling] => [nextElementSibling] => [nodeName] => td [nodeValue] => The GE junction is a distinct border as seen normally in the left image. The distal esophagus is normally a pearl white hue, while the gastric mucosa is a pink hue. In esophagitis the hyperemic inflammatory changes make the border less distinct (right image) 01239b01.800 esophagus stomach GE junction gastroesophageaal junction inflammed inflammation GERD red swollen reflux esophagitis grosspathology Courtesy Ashley Davidoff MD [nodeType] => 1 [parentNode] => (object value omitted) [childNodes] => (object value omitted) [firstChild] => (object value omitted) [lastChild] => (object value omitted) [previousSibling] => (object value omitted) [nextSibling] => (object value omitted) [attributes] => (object value omitted) [ownerDocument] => (object value omitted) [namespaceURI] => [prefix] => [localName] => td [baseURI] => [textContent] => The GE junction is a distinct border as seen normally in the left image. The distal esophagus is normally a pearl white hue, while the gastric mucosa is a pink hue. In esophagitis the hyperemic inflammatory changes make the border less distinct (right image) 01239b01.800 esophagus stomach GE junction gastroesophageaal junction inflammed inflammation GERD red swollen reflux esophagitis grosspathology Courtesy Ashley Davidoff MD )
DOMElement Object ( [schemaTypeInfo] => [tagName] => td [firstElementChild] => (object value omitted) [lastElementChild] => (object value omitted) [childElementCount] => 1 [previousElementSibling] => [nextElementSibling] => [nodeName] => td [nodeValue] => [nodeType] => 1 [parentNode] => (object value omitted) [childNodes] => (object value omitted) [firstChild] => (object value omitted) [lastChild] => (object value omitted) [previousSibling] => (object value omitted) [nextSibling] => (object value omitted) [attributes] => (object value omitted) [ownerDocument] => (object value omitted) [namespaceURI] => [prefix] => [localName] => td [baseURI] => [textContent] => )
DOMElement Object ( [schemaTypeInfo] => [tagName] => td [firstElementChild] => (object value omitted) [lastElementChild] => (object value omitted) [childElementCount] => 2 [previousElementSibling] => [nextElementSibling] => [nodeName] => td [nodeValue] => The Normal (left) and Abnormal (right) Red and Swollen GE junction – Reflux Esophagitis [nodeType] => 1 [parentNode] => (object value omitted) [childNodes] => (object value omitted) [firstChild] => (object value omitted) [lastChild] => (object value omitted) [previousSibling] => (object value omitted) [nextSibling] => (object value omitted) [attributes] => (object value omitted) [ownerDocument] => (object value omitted) [namespaceURI] => [prefix] => [localName] => td [baseURI] => [textContent] => The Normal (left) and Abnormal (right) Red and Swollen GE junction – Reflux Esophagitis )